Abstract
Cardiomyopathies are a group of structural and/or functional myocardial disorders which encompasses hypertrophic, dilated, arrhythmogenic, restrictive, and other cardiomyopathies. Multimodality cardiac imaging techniques are the cornerstone of cardiomyopathy diagnosis; transthoracic echocardiography should be the first-line imaging modality due to its availability, and diagnosis should be confirmed by cardiovascular magnetic resonance, which will provide more accurate morphologic and functional information, as well as extensive tissue characterization. Multimodality cardiac imaging techniques are also essential in assessing the prognosis of patients with cardiomyopathies; left ventricular ejection fraction and late gadolinium enhancement are two of the main variables used for risk stratification, and they are incorporated into clinical practice guidelines. Finally, periodic testing with cardiac imaging techniques should also be performed due to the evolving and progressive natural history of most cardiomyopathies.
Highlights
Cardiomyopathies constitute a heterogeneous group of diseases that affect the muscle of the heart and present a very diverse etiology
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T1 and T2 mapping techniques may identify the presence of early myocardial dam‐ age before the onset of myocardial fibrosis
Summary
Cardiomyopathies constitute a heterogeneous group of diseases that affect the muscle of the heart and present a very diverse etiology. The patient evaluation includes anamnesis, physical examination, an electrocardiogram, and transthoracic echocardiography (TTE) that may raise suspicion of cardiomyopathy This information is usually complemented with a cardiovascular magnetic resonance (CMR) that provides more precise anatomic and functional evaluation, as well as excellent tissue characterization with prognostic implications. LGE is a frequent finding in HCM (about 60% of patients) [6,11,12,13], correlates with the presence of myocardial fibrosis [14], and usually affects the most hypertrophied segments with an intramural pattern. LVOTO, LV systolic function (LVEF and GLS), LV diastolic function (E/E’), dynamic mitral regur‐ gitation (usually secondary to SAM) and tricuspid regurgitation (TR) velocity should be evaluated at rest, at peak stress, and post‐exercise (Figure 6) [24]. LVEF < 50% Abnormal GLS Presence, extension, and progression of LGE Increased T1/ECV values
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